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Myelogram findings and my back pain

hotcoffee29hhotcoffee29 Posts: 327
edited 06/11/2012 - 8:41 AM in Lower Back Pain
Hi all,

I am just curious if anyone out there has similar findings and what symptoms it might cause, I am not looking for a diagnosis and I know none of us are medical proffessionals, my surgeon did go over my results with me but made out that none of it was a big deal

At the L3-4 level there is a mild circumferential disk bulge causing flattening of the ventral thecal sac.

A L4-5 level there is a circumferential disk bulge causing flattening of the venral thecal sac.

At L5-S1 level, there is prolapse of the thecal sac towrds the laminectomy site. Mild disk bulge venral to the descending S1 nerve roots. Granulation tissue cannot be excluded. No recurrent disk herniation, no central stenosis or neural impingment.

I am 6 nmonths post op laminectomy/diskectomy at L5-S1 with cntinued low back pain and sciatica down my left side with left foot numb......doc says myelogram didn't show anything much excet he saw "something" at L5-S1 that may be plaque or a calcificatin growth, radiologist and him do not agree on what it might be, but that may be whats causing my symptoms, he said he may have to go in and take a look, I am awaiting to hear from him with his recommendation. He gave me nerve root block injection and it did help with the leg pain, not the back pain. The office called me a week ago to see how I was doing and said they would get back with me........????? still waiting, lol

I am handling it all, staying positive and remaining hopeful. I am just curious what anyone else thinks of my results or if hecal sac flattening and prolapse really isn't a big deal, I guess if its not impinging on any nerves.

One more thing, LOL.....the report also reads patient is post bilateral laminectomies at L5-S1, would this cause any weakness to this level due to it being bilateral? I thought I just had it on the one side of the herniation, again just curious and thinking out loud.

Thanks guys, your awesome!! And as always I do wish everyone luck and success on this board.



  • I am still adjusting to laptop and I see I miss alot of letters although I swear I hit them on my keyboard!!!
  • I have to assume that those disc bulges were probably there when you had your surgery in July....I doubt they suddenly formed after surgery...but, also remember, it is possible to have more than one pain generator.

    The spinal nerves run through the thecal sac below the L2 level. The twist together to form the "cauda equina" which runs through the thecal sac. Depending on how much a disc bulge is pressing into the thecal sac, it takes away space that would otherwise be occupied by this nerve bundle. This could be causing some neural compression, resulting in pain in your leg and foot.

    But also remember, MRIs also reveal abnormalities that do not generate pain. You wouldn't know about it were it not for the MRI image. Obviously your doctor is the one to make the call on this...so if he says "no big deal," hopefully, he is correct!

    I think something is still pressing on that S1 nerve root -- may be that undiagnosed "something" that he cannot identify.

    The fact that you had the laminectomy on both sides should not make a difference unless some instability has been created. That's what I've spent the last year trying to prove. I was convinced I had instability at L5-S1 but neither of my surgeons would concur and it was not indicated on the MRI. Finally the standing MRI I had showed just enough that my current surgeon started doing further investigation...and now I'm having a 3 level fusion to resolve the instability. But, in and of itself, the fact that you had laminectomy on both sides would not automatically be a problem.

    Did you recover from the effects of the myelogram??

    xxx Gwennie

  • I was never so happy when my symptoms from the reaction to the myelogram started to go away, the steroids really helped.

    I have been having alot of low back pain lately, more than I was and sometimes I feel weakness in my back which was why I asked about the double laminectomy.

    Since the nerve root block injection I have had some relief in my leg pain, I still feel alot of numbness and tingling in my leg and foot.

    I feel low back pain on my left and right side, I am curious to hear what my doctor wants to do next.

    I went to my PCP and gave him the copies of my MRI and myelogram and asked if if I should seek a second opinion and he told me no, he said my doctor has done all the tests and backs are complicated and just because I saw someone new doesn't mean they would find out whats wrong since I am alreaady seeing one of the best doctors in the area, I was quite surprised by his reaction.

    I had the disk bulge at L4-5 before surgery but not the one at L3-4 that I was aware of, no mention of it in my MRI's, I was just really curious about the flattening and prolapse of the thecal sac which I am glad you explained to me. I agree that I think that something is still pushing on that nerve at L5-S1, and perhaps it is the unidentified "thing" seen on the myelogram!!!

    I hope your fusion is successful for you Gwennie and brings you the relief and stability in your back that you have been waiting for. Thanks for all the wonderful info as always my dear friend.

    Take care
    Sandra xx
  • Depending upon the radiologist and the thickness of the slices done during your previous MRI, you could have had all that is listed now, back then. Some radiologists are far more thorough than others.

    I like what your PCP said in response to you questioning if you should get another opinion. I had several medical professionals and even another neurosurgeon telling me to get another opinion when I had problems after my first and several successive lumbar surgeries. I felt it would have been a mistake, because the current surgeon knew my spine and me, better than a new surgeon could in one or two office visits. Besides, the surgeon was consulting with all the same neurosurgeons and neuroradiologists that I would have had available to meet with.

    Anyway, my point is, that unless your surgeon has given up on you, it may be s smarter move to give him a chance to figure out what is going on.

    And yes, there are just some things that cannot be seen via imaging studies. I had L5 snapped clean through and because I was lying still in the MRI and X-rays, it couldn't be seen. It wasn't found until the surgeon open things up and went to set a retractor. Imagine his surprise.

    I know it stinks to have to wait what seems like an eternity when we feel so lousy, but in the grand scheme of things, a little patience can pay off big. When we rush things and become impatient is where we make bad decisions and develop regrets.

    Hope you have a decent week.

  • Wow, incredible that your surgeon did not find something so substancial in your spine until he was actually in there!

    I do agree with you regarding my surgeon, Gwennie and I discussed this too, that it is more comforting to be with the surgeon who knows our back best. I think I was worrying that I was with the wrong doctor due to hearing so many getting second opinions and my co-workers are always saying, if I am no better and I am not fixed yet, am I still going to see this doctor, they don't understand how complex the situation is, I had surgery and now I should be better. I got alot of slack too after my reaction to the myelogram but I had to explain that it wasn't my doctors fault and who knew I would react that way.

    During my last visit, my surgeon explained to me that something is not right, I should be able to play football if I want to and we'll figure it out, so he really is hanging in there with me, so I do feel I owe it to him to stay with him, even if it means going through the explatory surgery, but I probably won't jump into any surgery until the summer again so I don't need to take any extended time off work.

    Thanks "C", I do continue to remain hopeful and I will work on my patience, lol

    I hope things are going well for you too and your getting through this nasty winter.

    Take Care,
  • Sandra:

    I don't know much about MRIs, the lingo but my case was a little bit similiar to yours. I had a herniated disk at L5-S1. I had back pain and sciatica down my right leg. I dealt with it for 8 years, MRI's epidurals, etc.... 2 years ago I had a Laminectomy and disectomy, which ended up being just a laminectomy, the doc said when he was in there the disk was moving so well he didn't do the disectomy. Anyway time went by and but the pain stayed and I felt like I was less stable. I bugged the docs, which was more epidurals, etc...... And the MRIS did not show anything conclusive but I was still in pain.

    I waited 2 years and the pain was there the whole time, got worse actually, and changed insurances and changed doctors to the Ortho that I wanted to go with, the one I actually wished I had done to begin with in Atlanta. We'll this time the MRI showed my L5-S1 had changed, DDD Degenerative Disk Disease, and my new doc said fusion, which I had done 8 days ago ALIF by the way. I'm way too early to say if success or not.

    But overall I would suggest get a 2nd opinion, if you have a Neuro, you might want to talk to a Ortho, or vice versa. Thats the thing, I had to wait 2 years before the MRI caught up to my symptoms, that I was feeling then. Good Luck


  • I appreciate you sharing your story and I have read some of your posts. I hope you are healing well from your surgery and I do pray that this will be successful for you.

    I have had many test and yet to find exactly what is still causing my pain so it can be very frustrating, my nex appointment is on the 23rd, I have a feeling I will get another nerve root block injection. It helps with my leg pain but not with my low back pain, he did think I was going to need a fusion also but my discogram was negative, but he has also mentioned going in to take a look at something that is on my vertabra at L5-S1 as that could be the cause, very complicated and if you read my latest post I am dealing with the possibility of my teenage daughter going through surgery and possibly facing a fusion in her future, and I know how back pain is and that having surgery isn't always the fix.

    I will keep updating as I get more news and what my doctor is recommending and maybe like you, I may need to switch to have a new set of eyes to look at my situation.

    Thank you and my very best wishes go out to you as you mend, please keep me posted on your recovery, I'd love to hear that your pain is gone and its a success.

    Take care,

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